OBJECTIVES : The Covid-19 pandemic disruptively reduced the access to essential care, especially for diabetic patients. Continuity of care and adherence to drug therapy are essential for proper diabetes management. Moreover, diabetic patients are at higher risk of COVID-19 adverse events. Even though the Tuscany region pharmaceutical service ensured the routinely supply of pharmaceuticals, the strict restrictions due to lockdown might heavily affect people movement, especially frail people encouraged to ‘stay at home’. Our study explored whether (and how) lockdown measures in Italy affected the non-hospital supply of antidiabetic pharmaceuticals by employing Tuscany as a case study.

METHODS : We conducted an interrupted time series analysis to estimate changes in the non-hospital supply of antidiabetic pharmaceuticals focusing on transitions from the pre-Covid-19 era period to the nationwide lockdown period, started on March 11, 2020. We analyzed 10 years series of data collected between January 2000 and September 2020 by the Drugs and Appropriateness Department of the Tuscany Region.

RESULTS : We found a notable increase in the non-hospital supply of antidiabetic drugs immediately after the implementation of the lockdown measures. Subsequently, the supply returned to reference levels and then collapsed in September 2020. The drop of the supply was observed in the Centre area of the Tuscany region, which presented the greatest rise in Covid-19 infections.

CONCLUSIONS : Lockdown measures seemed to have a little impact on non-hospital supply of antidiabetic drugs in the first epidemic wave. Therefore, government strategies ensuring the continuity of care (e.g., dematerialized prescription) guaranteed the resilience of the regional pharmaceutical system. However, the supply drop detected at the beginning of the second wave (September) is alarming. Further analysis is required and will be carried out to understand the current situation and monitor future trends.